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Monday, 30 July 2018

Open Mike: If You Are Depressed (OT)

I won't lie—I've been going through a tough time lately. To my huge relief, though, my depression seems to have lifted in the past day and a half. I'm back to feeling blessedly...normal. A fragile-seeming state, which I dearly hope will last. And so, before I depart for my regular Monday-morning pool group, a brief public service announcement for the benefit of other people like myself....

My brother Charlie and I play a game in which we try to name the biggest changes of our lifetimes. (He was born in 1959, I in '57.) Personal computers took the number one slot for a while, then the Internet; now it's smartphones. But we each have other ideas as well. For example, the improved reliability of cars makes my list. Well, Charlie's a medical doctor (double-boarded in pediatrics and internal medicine), and one of the items on his list is the effectiveness of antidepressants.

I should write a book about the vagaries of language and their semi-unconscious effect on our con- and perceptions. One negative example is the fact that "depressed" is common slang (yes, slang, when used in this context) for "feeling kinda low." We all have mood swings. It's truly too bad that we say things like "I'm so depressed!" when we don't happen to be feeling happy, bubbly, and full of fun. Clinical depression, which I've suffered from intermittently since early adolescence, is not a normal or ordinary state. It's a different beast altogether.

And it's not remotely benign, either. To put it simply, depression kills. It's a big killer, too. It deprives sufferers of hope, and hope is one of the essential necessities of life—a mental/psychological one, yes, and maybe not quite as essential as air or water, but right up there with shelter and group alliances. The statistics are not hard and fast, but roughly as many U.S. Americans will die of suicide caused by depression this year as will be killed in automobile accidents.

Help exists, and it's getting more effective. If you, or especially your children (who can't demystify it for themselves) are suffering from persistent feelings of sadness and hopelessness, I urge you to seek medical help. Working with a prescribing psychiatrist (i.e., no accompanying talk therapy), I was on a course of antidepressants from about 2001 to mid-2005, and it changed my life...it "raised my low" considerably. Although I still have a tough time with the disease from time to time (can't lie), I can honestly say that I never get as depressed now as I used to get all the time.

It's no accident that TOP started just after mid-2005, after my doctor decided the course of antidepressants had been successful, and I had slowly become convinced that the black dog was safely in abeyance.

It's very tough to see hope when it's been taken away from you. But if you too are depressed, there is hope. Seek it.

More soon. I'm very excited to see my pool-playing friend Norm today—he finally shot below his age last week on the golf course! An 89 at age 93. His longtime goal. Awesome*!

Mike

*Translated to British: Brilliant.

"Open Mike" is the anything-goes, off-topic Editorial page of TOP. I'm on very shaky ground mentioning that it's supposed to appear on Wednesdays.

Original contents copyright 2018 by Michael C. Johnston and/or the bylined author. All Rights Reserved. Links in this post may be to our affiliates; sales through affiliate links may benefit this site.

(To see all the comments, click on the "Comments" link below.)Featured Comments from:

Dan Gorman: "Many thanks for this, Mike. I've never suffered from clinical depression myself, but I have family members and close friends who do, and from what I've observed, your explication is spot on. Your honesty and empathy are part of what makes TOP so special. If only a handful of your readers take your advice and get medical help, then this may be the best post you've ever written. Best wishes."

Richard Parkin: "Awesome*!

*Translated to British: Brilliant**

**Translated to English: Not half bad***

***Translated to Yorkshire: Champion."

Tom: "I learned only yesterday that an old friend had chosen to end her life after many years of depression and spells in and out of hospital. I feel a sense of guilt that I could not help although rationally I know there is little I could ever have done. Thank you for this post Mike, there's nothing I can add by way of comment other than to say I stand in solidarity with you."

Comments

I might be reading this wrong, but you seem to be suggesting that stopping antidepressants is what got you to start this site, which many of us consider a wonderful thing. You might want to expand on that - I think tacit suggestions for people to stop taking antidepressants in order to make amazing things (this blog!) can be dangerous. My wife will be a lifelong antidepressant user and I've seen how horrible things can get when she attempts to stop.

[I changed that part of the post to make it more clear. Thanks for the help. --Mike]

You had me laughing by your identification of "the improved reliability of cars" as on your list of lifetime's biggest changes – and I write as one who owned second hand British cars in the 1960's and 70's! But I can think of about a thousand things off hand that were much bigger life changers than that!

Two stories-related to this post, your previous post, and for that matter, to life in general.
I too fight with severe depression and hear you. It is something no one can begin to understand who doesn't live it and even when you do you cant truly understand what others suffering the same thing feel.
More than thirty years ago, when I spent some of the most alive days of my life out in the Big Bend of Texas, I would try to time my passage through Ft Stockton to be at the Comanche Tortilleria around 7am. Just to get fresh tamales! They wouldn't be open but Mr Gallegos, the owner, would be there finishing the steaming of his handmade tamales. He would sell me a few dozen and I would sit on the sidewalk eat till I was stuffed- then head on. Very Happy! One year he gave me a key chain that has hung on the dash of my truck ever since. It says simply......
You Can Make It If You Try

Then theres the motto I have declared to be my families.....
Too Stupid To Stop !

I'm a fellow sufferer and hit an especially bad phase some ten years ago. I was reluctant to try meds, so many scary anecdotes sprinkled all over the web.

I finally did and, like you, the little pills opened a metaphorical door enough to let in some rays of light... as well as jump starting a streak of creativity. Took them for a few months and weened off with no issue.

In my experience People that haven't had clinical depression just can't relate. There's no lifting yourself by the boot straps when every moment feels flat and gray.

For someone who suffers from depression you sure are productive and maintain a positive outlook. Thank you for sharing your struggle and alerting others to take care of themselves and their loved ones.

Good article. No one who has not suffered from depression can begin to comprehend the effects, and the frustration at not being able to control it.
In my teens and early twenties (50-60 years ago) I was suffering from a relatively mild form of depression. It drove me up the wall that I could never identify any reasons for its cyclical onset and retreat, and could do nothing to help myself.
Fortunately, the issue disappeared in my mid-twenties and has never returned - and it WAS just simple good fortune, as nothing I did seemed to help. I was also fortunate that the form I had was relatively mild, as I am not sure how I would have coped if it had been worse.

So glad you posted this. I have family members who have suffered in this way. I think in general there's a whole lot more attention we need to be spending on mental health generally. So many problems that are foregrounded in our consciousness now seem to me to be traceable back to aspects of mental health. And while there seems to be a fair amount of writing about mental health and modern life, I don't know of much that is connective across cultures and time periods,ages, gender(s),education,childhood background, developed world and un-developed world, & etc.

Seems like a matrix is needed, that could be developed as we learn more. And it seems to me that visits to the doctor ought to include some mental health check-up. The little (very!) I get from my otherwise fine doctor is perfunctory at best. Shouldn't this be assessed like blood pressure, blood work, weight, & etc?

Sidebar: good idea for an OT topic, biggest changes over your lifespan! I'm 62, close to you. It's been a lot!

Depression needs to be talked about, but like with other health issues, it's very personal, and everyone has opinions.

My wife, a family physician, became depressed during residency (a not uncommon occurrence) and she has been on the drugs for 15 years or so. Because of side effects she would like to experiment with transitioning off of them, but it is extremely difficult to do so, and the drug companies do not provide the minute tapering doses that are needed. So we have to resort to buying a precise digital scale to try it ourselves, which is messy and ridiculous.

I've been oddly resistant to depression most of my life, even though I'm diagnosed as bi-polar. Seem more prone to anxiety, and very stable on my meds, if a little less ambitious. My dad suffered the full-blown, bed-for-weeks, suicidal version of bi-polar. Not pretty.

Anyway, I know of no ideal solutions, but being involved and connected with others in your community seems to be one of the cheapest forms of treatment. Doesn't always help, of course, but on average...

Long time readers can tell that from time to time, something is 'different'. You have more than readers, you have sort of an extended family who care about you. We can't, of course do anything to help unless knowing that lots of others care is helpful.
Lots of us have at least indirect experience with depression and know everything you said is true.

It's time to do some print sales to fund renovating your 'barnette' into a Pool hall / Gallery/ Studio
You could even do the printing to amortize the cost of the printer, or be a custom printer again.......
You come back again and again to the joy playing Pool brings you.
You could then host Mondays with Norm at the TOP Pool Hall--- Who knows, maybe there is a book in it.
You Love Pool, you own a nice table, and an audio system for ambiance. You are down the road from Amish builders.
If the thought of that makes you happy, you have your answer.

Enjoy your Day, say Congrats to Norm and BTW where is the Norm Portrait ?

I've left you a total of two comments over the years; that total includes this one. I'm not much of a public commenter. I've felt the pace and energy of TOP slow, just perceptibly, over the last few months, and wondered if you were well.
I'm writing to tell you something I'm sure you know, but that you may need to hear again and again. There are thousands, millions, of us who battle depression either chronically or episodically; you have company.
You and TOP are a fixed star in my sky. I count on you, in this increasingly absurd world, to be a pillar of serenity and old-world sensibility (that's intended as a compliment).
Know that there are legions of us who value what you do, and wish you well.

That's a pretty vital component for all of us mortals, and I have concluded that it really underpins most of what we do, want to do and eventually manage to accomplish.

I'm not a religious person in the bible-thumper sense of the term, but I do have a sense of a god of some sort, a prime motivator for everything there is and, also, of what we may of may not accomplish on our own. It seems to me that life is just too complicated for chance to have been the provider of our individual paths through it. Chance would only provide chaos and can we really claim our lives are that? I certainly can't.

Perhaps the most pressing need I have for hope relates to my late wife: if there was no "plan" written on some tablet somewhere, it seems highly unlikely to me that we would ever have met, never mind spent our lives together. Hope offers itself up as the means of reunion at some later stage in this game. Remove that hope and there is just no point in anything, in children, grandchildren, any close relationship. There is the possibility that I could be mistaken, as I often am, but then if that's the case, I shall never know, and it appears to make more sense living in hope than not.

Don't think of hope as the missing part causing depression; think of it as the way out of depression, and consider how it (and for some) its close neighbour religious faith have taken people through lives of slavery, torture, repression and every form of known hell, and out the other side. Don't let a definition define your situation. Many things seem impossible because we become conditioned to believe them so to be.

As somebody else pointed out, you write very well, so why not use the gift in the manner that comes naturally, not try to force it into a mould that may not really suit you or your ability? It seems highly likely that depression and frustration with something have powerful links in maintaining the status quo.

Best of luck - just don't do as I do and find yourself tapping keyboards when your eyes just want you to go to sleep!

Mike, thank you for being open enough to discuss your experiences, and encouraging others to get help. You really nailed it with the hope part. I have also been lucky enough to get some relief with medication and lifestyle changes, and I found hope again :)I always love reading TOP, both for the photography and the always excellent off topics.

I figured something was up. I'm pretty good at reading between the lines/pages. While I am loath to speaking about personal things on the open net lets just say I know what your going through. Keep on keeping on Mike.

Thank you for writing this. I don't suffer from clinical depression as my episodes of depression are too short, but depression is ... bad: if I did suffer from clinically-long periods of it I am absolutely sure I would be dead, and as it is I am only here because of my wife who, without understanding what it is like (because you can't, I think, without experiencing it, and you do not want that), looks after me when I am not really there at all.

What I really wanted to say, though, is this: when you were born about half the people in the world were living in extreme poverty; today less than 10% are. That is, without doubt, the biggest change in your (and my) lifetime: it's also a change which can give hope in the face of our idiot leaders who want us to believe the lie that everything is in a state of decline which we can only deal with by treating people different than us as less than human. In the last 60 years we have made billions of people's lives worth living. Billions: that's a thing to be proud of.

As a lifelong sufferer I can empathize. I'm not sure about the efficacy of the meds though. There's a lot of studies that indicate that in general they aren't much better than a placebo, though I guess for some people they work wonders. I envy those people. I'm interested in what others have to say, and if their meds have impacted their creativity one way or the other.

Hi Mike, I am completely unqualified to comment, but ran across this YouTube video a couple weeks ago where Dr. Jordan Peterson describes his family's experience on the subject. Dr. Peterson is a clinical psychologist and a personal sufferer of depression so is qualified. If you haven't watched any of his lectures you might want to listen to his mainstream intellectual material before jumping into this rather personal segue so you have context of the man. https://youtu.be/KGikB-54Lwk

Unfortunately, I know what you’re speaking of. I’m usually fine, but some of life’s setbacks can bring on the ‘black dog.’ When I was younger, talking with friends and telling myself that my life was actually fine even though my brain was going haywire, got me over the bad spells. Several years ago, it hit me like never before and I still consider the period until the Lexapro kicked in the most potentially lethal time of my life. Only occasional doses of Xanax, brisk walks, light reading of Alexander McCall-Smith and PG Wodehouse, my wife’s support and the rational thought that I actually had a great life made me strong enough to wait for the drugs to bring me back to my more optimistic self. Luckily, I now know the warning signs and I can take action early. I agree only those who have experienced it, know the true devastation depression can bring. And Mike, my life would be less enjoyable without your writings, so keep it up! Also, you have a great son and a life to share with him, just like I have two great kids and I’m looking forward to growing older with them in my life.

Mike, I am torn between wanting to write, and wanting to desist, as I'm sure many well-meaning folks over the years may have offered nice-sounding but useless "advice."

Other than occasional bouts of low moods, I have never suffered a real depression, but my first wife did. It was postpartum, never lifted, and was accompanied by a severe OCD. From the outside looking in, I could sense, but not feel, how she suffered. A couple of times, she tried unsuccessfully to ween off the medications. It was distressing to see the external changes in her appearance. At the time of onset, in the mid 60s, depression was even less understood by the general population than it is today. The medical profession was just starting to come to grips with methods to deal with it, antidepressant medications being the most successful. Her own family, old school folks, were baffled by her sudden change in behavior, and her wanting to minimize contact with them, and they blamed me for it. Somehow, we worked out a way to , barely, manage around her depression and OCD, enough to let me go to work and keep the household going. I'm reluctant to say more, not wanting to turn my comment into a confessional.

However, I do want you to know, there are many of us who either are experiencing, or have experienced depression, or who have loved ones who do. We are people who you can enumerate as understanding supporters in your struggle.

One more thing: there is a person who comes out when you write, who is not the depressed individual you portrayed. Keep writing this blog, and other stuff, Mike! It's good for you.

This will probably seem a little far fetched for some. But for those of you having to deal with depression it may be one of those things that helps. Sure helped me.

There is increasing evidence that mental ilnesses may have an inflammatory cause. In my case this turned out to be absolutely the case. For me it was a chronic infestation with the gut bug Helicobacter pylori. Once I got rid of this little sucker, everything changed for the good. My mood, my energy, my sleep, my aches and pains and life in general. It's pretty simple diagnosis and fix. Worth a try I reckon. BTW: The researchers who nailed this thing down, mostly as a cause of a whole raft of gut issues, are from Perth Western Australia. Barry Marshall and Robin Warren. They won a Nobel prize for their research. Good luck.

I love and respect statistics. But in my personal environment there were six suicides and only one fatal car accident. Which I more or less regard as suicide as well because the respective girl was obsessed with Formula 1.
No alcohol victims, unless I count a former business partner who died early of Alzheimer as one. The real killer is tobacco.
I estimate that in my family 90% of the generation before me died early because of smoking. Among them my father and all his six brothers.

At art school I had a depression and later in my mid-thirties too.
I never used pills, but I developed many tactics to avoid the causing obstacles as much as possible. In fact I don’t take life a lot less serious and I am more concerned about my wife than about myself. Also it’s easier for me to accept those suicides than car accidents or the epidemic of tobacco victims.

I am one of those for whom being depressed has indeed just meant "feeling kinda low" so I can't really comment beyond that. Except to say of course that I am glad that you're feeling better, and I hope it stays that way.

I was interested in your paragraph about "biggest changes in your lifetime". Rather than go for personal tech changes - computers, global communications systems, the death of paper maps (a particular sadness of mine) or anything like that, I'd go for the levelling-up of nations. Have you read "Factfulness", by Hans Rosling? Written for a western audience, it documents the changes in the world as a whole. Here's a link to a page featuring some of his basic "what do you know about the world?" questions: https://www.theguardian.com/global-development/quiz/2013/nov/07/development-data-population-quiz-hans-rosling . It's an interesting read that challenges many of our assumptions about the world, especially for those from our generation.

So you somehow manage to maintain TOP, write new and interesting posts and what not, even when, in your softly spoken words, you're going through a tough time. No small feat. Though the power to manage a bout of depression in this way is also a gift, like everything else when you come down to it (those who don't have it cannot help it), you have my deepest respect. What resilience!

Since I remember (actually it's not true but it sounds better) I had depression episodes, usually mild ones but frequent. I never tried to get help because I didn't think I needed it. I also suffered from some stomach problems. Three years ago both my depression and stomach problems god worse but I did not see any connection between these conditions yet. Finally I saw a doctor and started dealing with my stomach first. By accident I found out I have food allergies. I started avoiding certain products and my mood improved significantly too. Two years ago I started experimenting with low carb diet to lose weight and I noticed it improved my mood as well. This got me thinking, and reading, and experimenting.
In short: what you eat affects your gut and it affects your mind. I never felt so good in my whole life. Still not everything is perfect but I'm getting there day by day.
I know it might not help everybody but for people who have problems with mood AND digestion AND body weight I highly recommend following books:
* The Mind-Gut Connection, Emeran Mayer - the title says it all.
* Why Zebras Don't Get Ulcers, Robert M. Sapolsky - it's about physiology of stress but there's a chapter about depression too.
* The Gut Balance Revolution, Gerald E. Mullin - how to cure yourself.

Working with families over 30 years I would thoroughly endorse getting help. I don’t know other physician’s experience but mine would say that one in three people are transformed by SSRI drugs, one in three are helped, but one in three are either not helped or sometimes even made worse.
It is IMHO watching people carefully to see how they respond. Particularily because of this I think it is important to treat people individually and in a way that works for them. So there is a group where talking and helping and being there for your patient becomes doubly important.
On average I would guess that men respond to practical help in how to handle these terrifying moods such as CBT and women maybe more often respond to general support.
SSRI s which can be almost magically transforming to some people are disappointing for others. My guess is that depression is a very multifaceted illness.
In my view the importance of having a physician as someone you know and can trust is one of the reasons for having someone you know as a doctor and why the loss of this in the UK is so disadvantageous. Although working with someone with severe depression is hard it can be one of the most rewarding parts of a doctors life.

I think that there has been one of those great changes recently in that mental health is becoming easier to talk about. So thank you for helping by being so candid. Two well known British photographers took their own lives because of depression - Bob Carlos Clarke and Terence Donovan.

I read somewhere that depression is a disease of modern times. I wouldn't know; I've been depressed but I've never suffered from clinical depression even when life did a downturn. I can't understand how someone like you - obviously knowledgeable and willing to share your time and talents with others - can suffer from depression. How can someone so deep into major life support systems like books and photography succumb to this malady? In case you haven't tried them already, maybe you could go through Fritjof Capra's 'The Tao of Physics' along with Mani Bhaumik's 'Code Name God' and Paramhansa Yogananda's 'Autobiography of a Yogi'. Or take up fishing.
I'm serious.

To my associates, friends and family members who suffer from mild to severe depression, I extend my apologies. I'm sorry for having offered simplistic solutions to your physical problem. Those solutions sounded good to somebody whose brain chemistry was within the norms, but were useless - even insulting - to you. You had done nothing to deserve your affliction, and you couldn't "just snap out of it."

I have a new respect for the delicate chemical balance that generates what others call our personality. To those of us whose bodies sometimes fail to maintain that balance, all we can offer is our understanding, and our encouragement to keep trying new therapies. For more and more people, medicine can provide the answer.

Mike, I'm glad you found your answer. Thank you for having the courage to pass it on.

Mikes story - like many - often contains a little phrase like "I've always battled this", or "ever since I was young", etc. And most readers think to themselves well thank god thats not me, I dont get depressed. I know I thought that.

So when at 50 for no apparent reason all these things others have described happened to me, my answer was "I dont get depressed - its not that". Well it was - I was depressed, and it went unreported and untreated for 2 years and while I held most of my life togther its cost me a lot I wont ever get back.

For me the cause was was a result of a thyroid gland that decided it had had enough (who knew hypothyroidism comes with a side order of depression). For others it may be something else. The point is we are fragile, we may be strong one day and terribly broken in ways we dont even know the next.

I'd like to say to those reading Mikes story and thinking - like I did - that it wont happen to me, just always be open to the idea that this just might and we all need to watch out for ourselves and each other.

I have had my troubles with it over the years, and through therapy I’ve mostly been able to change my response to it mentally, although it still takes work.

I was listening to a very famous person (who I won’t name here, but will refer to as DG) talking about his battles with depression. DG lived in L.A., and wanted to see a particular therapist who had turned him down after their first meeting. When asked why, the therapist said he was older, nearing the end of his career, and would not be in practice long enough to help this fellow.

I know, right!

So DG said he would come everyday for therapy if that would convince the guy to treat him. The therapist agreed, and along they went for a few years. Then the therapist told him they were finished. DG said ‘What do you mean? I am still hearing the voices.’ To which the therapist answered, ‘Oh, you always will.’

DG (and this was his account of it) said, ‘What am I supposed to do?’
The therapist said, ‘You have to ignore them.’

So that was very impactful for me to hear. It wasn’t new, but in telling his story, DG had given what all of us want, which is to know that we aren’t alone, and in this case, that this stuff will continue to affect us but we have to find ways to deal with it.

Brian Dawkins, a former Philadelphia Eagle, is being inducted into the Hall of Fame this week, and he has been in the news the past few days for his struggles which he just admitted publicly. It has gotten a lot of coverage and thanks in the sports media.